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NPI Code Detail

MEDICARE: DR. DAVID R GUILLEN M.D.

MEDICARE:  DR. DAVID R GUILLEN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZD0900XDermatopathology (Pathology) Physician202004826NC

General Provider Information

NPI Number : 1033120290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID R GUILLEN M.D.
Provider Business Mailing Address
First Line : 1072 XRAY DR
Second Line : SUITE B
City : GASTONIA
State : NC
Zip : 28054
Country : US
Telephone Number : 704-671-1094
Fax Number : 704-671-1094
Provider Business Practice Location Address
First Line : 1072 X RAY DR
Second Line :
City : GASTONIA
State : NC
Zip : 28054-7488
Country : US
Telephone Number : 704-671-1094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 02/14/2023

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Directions to “ DR. DAVID R GUILLEN M.D.” Practice Location

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